Pattern of haematological diseases diagnosed by bone marrow examination in Yemen: a developing country experience.

There is lack of information about the relative prevalence of haematological disorders in Yemen and other Middle East countries. The aim of this study was to evaluate the pattern of haematological diseases diagnosed by bone marrow examination in Yemen considering the limited diagnostic facilities. At the referral haematology centre in Yemen, between November 1999 and November 2005, 785 patients >14 years old were evaluated by bone marrow examination. Relevant investigations were performed when needed. A total of 627 patients had haematological disorders other than lymphoma, and their data were analysed. There were 273 females and 354 males. A total of 159 patients had Acute myeloid leukaemia, 75 had acute lymphocytic leukaemia, 87 had chronic myeloid leukaemia, 36 chronic lymphocytic leukaemia, eight had multiple myeloma, 13 myelodysplastic syndromes, seven myelofibrosis, seven polycythaemia vera, three primary thrombocythaemia, two hairy cell leukaemia, two metastases, 36 aplastic anaemia, 29 immune thrombocytopenic purpura (ITP), nine autoimmune haemolytic anaemia, three pernicious anaemia, 65 iron deficiency anaemia, 57 megaloblastic anaemia and malaria, 18 mixed deficiencies, and 11 patients had visceral leishmaniasis. Sex- and age-related distribution of the various disorders was also presented. In conclusion, the leukaemias were the most frequently encountered diagnosis followed by iron deficiency anaemia, megaloblastic anaemia and malaria, aplastic anaemia and ITP respectively. The other haematological disorders were less common. These findings are comparable with that seen in other developing and developed countries.

Cyclosporine monotherapy for severe aplastic anemia: a developing country experience.

BACKGROUND: Immunosuppression is the most effective treatment for aplastic anemia after hematopoietic stem cell transplantation. Although the combination of cyclosporine and antithymocyte globulin (ATG) is superior to either agent alone, cyclosporine monotherapy is an easily available, safe and cheap immunosuppressive therapy (IST) option. These advantages are particularly valuable in developing countries where ATG is frequently not available. PATIENTS AND METHODS: In the referral hematology center in Yemen, 20 patients (16 males and 4 females) with severe aplastic anemia (SAA) were prospectively identified and managed with cyclosporine monotherapy during the period between April 2001 and November 2004. RESULTS: Data from 14 patients who received cyclosporine for at least 3 months were analyzed. At 6 months, 2 (14.3%) patients achieved complete remission (CR) and 5 (35.7%) patients achieved partial remission (PR) and at 1 year, 4 (28.6%) patients achieved CR and 3 (21.4%) patients remained in PR. The overall response rate was 50% and the cumulative survival rate at 1 year was 78.6%. The median time to remission was 120 days (range, 46 to 131 days). Side effects were modest and easily monitored. CONCLUSION: Our results support findings that cyclosporine monotherapy is an effective and safe immunosuppressive therapy for SAA, and that it could be a reasonable IST option for patients in developing countries.